The purpose of donor evaluation for adult‐to‐adult living donor liver transplantation (LDLT) is to discover medical conditions that could increase the donor postoperative risk of complications and to ...determine whether the donor can yield a suitable graft for the recipient. We report the outcomes of LDLT donor candidates evaluated in a large multicenter study of LDLT. The records of all donor candidates and their respective recipients between 1998 and 2003 were reviewed as part of the Adult‐to‐Adult Living Donor Liver Transplantation Cohort Study (A2ALL). The outcomes of the evaluation were recorded along with demographic data on the donors and recipients. Of the 1011 donor candidates evaluated, 405 (40%) were accepted for donation. The donor characteristics associated with acceptance (P < 0.05) were younger age, lower body mass index, and biological or spousal relationship to the recipient. Recipient characteristics associated with donor acceptance were younger age, lower Model for End‐stage Liver Disease score, and shorter time from listing to first donor evaluation. Other predictors of donor acceptance included earlier year of evaluation and transplant center. Conclusion: Both donor and recipient features appear to affect acceptance for LDLT. These findings may aid the donor evaluation process and allow an objective assessment of the likelihood of donor candidate acceptance. (HEPATOLOGY 2007.)
Electromagnetic launch science and technology in the United States is on the threshold of a major new advance in its development. Significant developments in hypervelocity electromagnetic launch and ...in hypervelocity high-G guidance and control components have provided the impetus for exploring advanced electromagnetic weapon systems capable of providing revolutionary new capabilities. These systems include the electromagnetic launch of aircraft from Navy aircraft carriers, hypervelocity electromagnetic guns on ships to provide protection and to launch guided projectiles to extraordinary ranges, and lightweight ground combat vehicles propelled by hybrid electric power protected by electromagnetic armor and capable of defeating advanced armor targets with lightweight hypervelocity penetrators from electromagnetic railguns. This presentation will summarize many of the technical advances leading to the decision to implement these new engineering efforts.
The genome organization in pluripotent cells undergoing the first steps of differentiation is highly relevant to the reprogramming process in differentiation. Considering this fact, chromatin texture ...patterns that identify cells at the very early stage of lineage commitment could serve as valuable tools in the selection of optimal cell phenotypes for regenerative medicine applications. Here we report on the first-time use of high-resolution three-dimensional fluorescence imaging and comprehensive topological cell-by-cell analyses with a novel image-cytometrical approach towards the identification of in situ global nuclear DNA methylation patterns in early endodermal differentiation of mouse ES cells (up to day 6), and the correlations of these patterns with a set of putative markers for pluripotency and endodermal commitment, and the epithelial and mesenchymal character of cells. Utilizing this in vitro cell system as a model for assessing the relationship between differentiation and nuclear DNA methylation patterns, we found that differentiating cell populations display an increasing number of cells with a gain in DNA methylation load: first within their euchromatin, then extending into heterochromatic areas of the nucleus, which also results in significant changes of methylcytosine/global DNA codistribution patterns. We were also able to co-visualize and quantify the concomitant stochastic marker expression on a per-cell basis, for which we did not measure any correlation to methylcytosine loads or distribution patterns. We observe that the progression of global DNA methylation is not correlated with the standard transcription factors associated with endodermal development. Further studies are needed to determine whether the progression of global methylation could represent a useful signature of cellular differentiation. This concept of tracking epigenetic progression may prove useful in the selection of cell phenotypes for future regenerative medicine applications.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Antibody‐mediated rejection (AMR) after liver transplantation is recognized in ABO incompatible and xeno‐transplantation, but its role after ABO compatible liver transplantation is controversial.
We ...report a case of ABO compatible liver transplantation that demonstrated clinical, serological and histological signs of AMR without evidence of concurrent acute cellular rejection. AMR with persistently high titers of circulating donor specific antibodies resulted in graft injury with initial centrilobular hepatocyte necrosis, fibroedematous portal expansion mimicking biliary tract outflow obstruction, ultimately resulting in extensive bridging fibrosis. Immunofluorescence microscopy demonstrated persistent, diffuse linear C4d deposits along sinusoids and central veins. Despite intense therapeutic intervention including plasmapheresis, IVIG and rituximab, AMR led to graft failure.
We present evidence that an antibody‐mediated alloresponse to an ABO compatible liver graft can cause significant graft injury independent of acute cellular rejection. AMR shows distinct histologic changes including a characteristic staining profile for C4d.
This ABO compatible liver graft recipient developed antibody‐mediated rejection, with a distinctive strong linear C4d staining along sinusoidal and central vein endothelium.
Stream dewatering is expected to become more prevalent due to climate change, and we explored the potential consequences for brook trout (Salvelinus fontinalis) within a temperate forest ecosystem in ...eastern North America.
We estimated fish density within stream pools (n = 386) from electrofishing surveys over 10 years (2012–2021) to compare a stream that exhibits episodic dewatering (Paine Run) against a stream of similar size that remains flow‐connected (Staunton River) within Shenandoah National Park, Virginia (U.S.A.). Annual surveys encompassed fluvial distances ranging from 2.6 to 4.4 km in each stream.
Mean annual fish density (fish/pool m2) was not different between streams for juvenile or adult age classes, but spatial variation in density was greater in Paine Run for both age classes of fish. Paine Run also included a greater proportion of unoccupied pools than Staunton River and exhibited stronger spatial autocorrelation in fish density among nearby pools, suggesting dispersal limitation due to surface flow fragmentation.
Fish density in pools increased during years with low summer precipitation, and this effect was observed in both streams but was stronger in Paine Run than Staunton River, further indicating the importance of fish movement into pools in response to low‐flow thresholds.
Our results indicate the importance of pools as ecological refuges during low‐flow conditions and that episodic dewatering may affect extirpation risks for brook trout by sequestering more fish into fewer areas. Our findings also highlight the importance of hydrological variation within stream networks because downstream river gages could not predict the observed spatial heterogeneity in fish density or pool occupancy.
This study focuses on characterizing the contributions of key terrestrial pathways that deliver dissolved organic carbon (DOC) to streams during hydrological events and on elucidating factors ...governing variation in water and DOC fluxes from these pathways. We made high‐frequency measurements of discharge, specific conductance (SC), and fluorescent dissolved organic matter (FDOM) during 221 events recorded over 2 years within four Vermont (USA) watersheds that range in area from 0.4 to 139 km2. Using the SC measurements, together with statistical information on discharge, we separated the event hydrographs into contributions from three terrestrial pathways, which we refer to as riparian quickflow, subsurface quickflow, and slow‐flow groundwater. The pathway discharges were used as input to a mixing model that closely approximated sub‐hourly streamwater DOC concentrations as measured with the FDOM sensors. Subsurface quickflow, comprised of pre‐event water, was the leading contributor to streamwater DOC fluxes, while riparian quickflow, comprised of event water, was the second‐leading contributor to streamwater DOC fluxes, despite comprising the smallest proportion of streamflow yield among the three end‐member pathways. Fixed‐effects regression analysis revealed that the relationship between DOC fluxes from the end‐member pathways and event magnitude was consistent across the four watersheds. This analysis also showed that DOC fluxes from the quickflow pathways increased significantly with temperature and varied inversely, but weakly, with catchment antecedent wetness. We believe that our approach, which leverages in‐stream sensors that enable high‐frequency measurements over extended periods, may be applicable for evaluating controls on DOC export from other watersheds within and beyond our study region.
Key Points
Calculations of a mixing model reproduce sub‐hourly observations of streamwater dissolved organic carbon (DOC) concentrations in four watersheds
Streamwater specific conductance can be used to quantify discharge from terrestrial flowpaths and constrain the DOC mixing model
DOC fluxes from principal flow paths vary discernibly with event magnitude, temperature, and antecedent wetness
Background & Aims: Reports of complications among adult right hepatic lobe donors have been limited to single centers. The rate and severity of complications in living donors were investigated in the ...9-center Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL). Methods: A retrospective observational study design was used. Participants included all potential living donors evaluated between 1998 and 2003. Complication severity was graded using the Clavien scoring system. Results: Of 405 donors accepted for donation, 393 underwent donation, and 12 procedures were aborted. There were 245 donors (62%) who did not experience complications; 82 (21%) had 1 complication, and 66 (17%) had 2 or more. Complications were scored as grade 1 (minor; n = 106, 27%), grade 2 (potentially life threatening; n = 103, 26%), grade 3 (life threatening; n = 8, 2%), and grade 4 (leading to death; n = 3, 0.8%). Common complications included biliary leaks beyond postoperative day 7 (n = 36, 9%), bacterial infections (n = 49, 12%), incisional hernia (n = 22, 6%), pleural effusion requiring intervention (n = 21, 5%), neuropraxia (n = 16, 4%), reexploration (n = 12, 3%), wound infections (n = 12, 3%), and intraabdominal abscess (n = 9, 2%). Two donors developed portal vein thrombosis, and 1 had inferior vena caval thrombosis. Fifty-one (13%) donors required hospital readmission, and 14 (4%) required 2 to 5 readmissions. Conclusions: Adult living liver donation was associated with significant donor complications. Although most complications were of low-grade severity, a significant proportion were severe or life threatening. Quantification of complication risk may improve the informed consent process, perioperative planning, and donor care.
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